Waiting for the Doctor

With his unhinged threats on raining Hell and to totally destroy a civilization, Trump's "cognitive decline" (the polite term) has finally become focused in the public discourse.  However, unlike most of the world looking at the way an out-of-control Trump raves he will commit war crimes, professional psychologists understand how illnesses work in ways the rest of the world has no training to, and come to the cause of his actions from a very different and unexpected perspective.  They see the underlying details and signals we don't.  Yes, dementia is an overriding issue in Trump's degenerating health, but the other day one of the leading experts discussed why something else entirely is cause for concern, perhaps even in the forefront.  We'll get to that in a bit.  First, though, I think it requires some background.  And so for that, we're going to return to the opening of an article I wrote six years ago, almost to the month.

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                                Is There a Doctor in the White House?
                                                       May 18, 2020

I'm not a doctor.  I'm not a psychiatrist.  I'm not a psychologist.  I have no medical training whatsoever.  My opinion is only that, and not worth a nickel more.

I am however able to read, and have read numerous articles by highly-trained, accomplished doctors and psychiatrists and see what they say -- admittedly from afar and only based on their knowledge of general symptoms that are basic to their fields.

Still, I don't think I'm going out very far on a limb to say that it's my amateur observation, based in part on what a great many experts write, that Trump has gone completely insane.  That he's every bit the sociopath, pathological liar and malignant narcissist as we've presumed for a long while -- but that it's gotten worse the past six months and is out of control.

And by the way, the expression "malignant narcissist" is not used as having just a sharp adjective in it, but rather it is a very specific medical term separate from someone being a mere narcissist.  In the simplest terms, it's like the difference between saying someone is "ill" and saying that they are "terminally ill."  Those are, of course, two critically different medical conditions.  

From a research paper on the The National Center for Biotechnology Information website, a research paper describes malignant narcissism as -- "a core Narcissistic personality disorder, antisocial behavior, ego-syntonic sadism, and a paranoid orientation."

On the Psychology Today website, an article by Rhonda Freeman, PhD, was posted in February, 2017 -- three years ago [NOTE: now nine years ago] -- titled "How to Tell You're Dealing with a Malignant Narcissist" and subtitled -- "The intentional destruction of others while pathologically loving the self."  After discussing general narcissism, Dr. Freeman then writes --

​A person with malignant narcissism has the potential to destroy families, communities, nations, and work environments. This condition reflects a hybrid or blending of narcissistic and antisocial personality disorders. Psychologist Eric Fromm termed the disorder in 1964. Psychoanalyst Otto Kernberg later delineated the symptoms of the condition and presented it as an intermediary between narcissistic and antisocial personality disorders.

Why is the behavior of malignant narcissism often considered dangerous?

Individuals with this profile can form connections with others. However, they process information in ways that can hurt society in general, but also the people who love or depend on them. Family, co-workers, employees, and others in their lives often have to walk on eggshells to appease a fragile ego and minimize the occurrence of their unstable, impulsive, or aggressive behaviors.

They lash out or humiliate others for infractions of even the most frivolous nature (for example, you gave an opinion that differed from theirs; you demonstrated confidence, and it made them look bad; you told a joke that involved poking fun at them).

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​You can read the full article by Dr. Freeman here.

Well, okay.  Moving back to 2026, I think it's eminently clear why this is being addressed today.  Trump's dementia is one thing, a subject being discussed prominently now, ever since he began his war of choice against Iran and then grew to megalomaniacal threats of annihilation.  But it's malignant narcissism that I think is even more important for looking at how he is acting.

Of course, what I think as a total layman about Trump's mental state is meaningless.  And what I wrote six years ago holds true:  I'm not a psychologist.  I have no medical training.  My opinion is only that, and not worth anything more.

Which is why I read articles by highly-trained, accomplished doctors and psychiatrists to see what they say.

One of the most prominent and unrelenting psychologists on Trump's cognitive decline, dementia and malignant narcissism has been Dr. John Gartner, a former professor at Johns Hopkins Medical School, who I've written about extensively.  He regularly explains all the signs that show Trump has dementia, which is degenerative.  Indeed, as he says, he always tell people to look at Trump now, “because it’s the best you will ever see him.”
 
And it was an article I read on Monday about Dr. Gartner's recent observations on Trump that deal with the subject -- but take it to a very different direction than any other analyses I've seen of his actions.

On The Daily Beast Podcast, Dr. Gartner issued a blunt warning about what he considers not just Trump’s malignant narcissism, but an addiction. Referencing Trump’s "rapidly declining" mental state, he made the point that Trump’s ego-driven bombast is becoming even more “inflamed,” which he believe has led him to develop a new addiction that has pushed us to where we are now.

"I'm worried that he's going to become addicted or he is becoming addicted to war because he gets off on it," Gartner said. "Remember when he put out that social media thing where they were splicing actual images of the missiles blowing stuff up with video games? They were glorifying it, kind of trivializing it, and having fun with it. They're still showing him videos of blowing stuff up every morning."
 
Dr. Gartner said that is addiction to war could be fueled specifically by his malignant narcissism.

"The thing that people need to understand about malignant narcissists is that they get more pleasure from this, which is the sadism from feeling powerful by harming and destroying and degrading other people and institutions, and in this case, countries," Gartner said. "So my fear is that Donald Trump is getting off on this. He is getting sadistic pleasure from scaring the world and blowing things up."

​You can watch the full discussion with host Joanna Coles below.  "How Trump's Speech Reveals Signs of Dementia."  As the show describes his conversation --

"Gartner, a psychologist and former Johns Hopkins University Medical School professor, breaks down what Trump’s language, fragmented phrasing, and escalating tone may reveal about cognition, impulse control, and stress, as other physicians publicly warn about possible signs of decline."
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The podcast runs 49 minutes.  For those who might be interested in just certain segments, here's a rundown of topics covered.  Just click on the links, and they will take you directly to those sections on YouTube.

00:00 - Easter Post Sparks Mental Health Alarm
03:48 - Malignant Narcissism Meets Dementia
07:40 - Aggression, War Talk, And Disinhibition
11:32 - Threats, Power, And Global Fear Dynamics
15:22 - Polls Drop And “Wounded Animal” Theory
19:10 - Physical Decline And Stroke Concerns
22:58 - “Good Days” Defense And Stimulant Claims
27:16 - Rambling Speech Example And Cognitive Drift
31:08 - Sycophants, Guardrails, And Escalation Risks
34:58 - War Addiction And Military Impulse Warnings
38:39 - Midterms Won’t Stop Escalation Fears
42:28 - Trump As Victim And Grandiosity Narrative
46:17 - Is The President In His Right Mind?
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